Types of Home Carer

What types of homecare workers are there?

In this section we will look at the different roles a homecare worker can fulfil, which vary depending on the shift patterns worked, the level and type of care provided, and finally the way in which a care worker is employed.

General types of carer

There are two basic homecare models: live-in care and visiting care (also called daily care, hourly care, or domiciliary care). Because these models are very different, those starting a career in care will generally specialise and work as one or the other but can do both depending on desired shift pattern and previous experience.

Visiting carers

Visiting care is a service whereby a client requires a carer to visit them for just a few hours a day or a week for companionship or for help around the house. This could be for several reasons such as aiding getting in or out of bed or accompaniment to appointments. This service is provided by a visiting carer who will work with multiple clients over the course of a single week. Visiting carers will usually live in their own home and find their own way to the clients’ homes. Read more about the role of a visiting carer.

Live-in carers

Live-in care is typically where the client requires a higher level of support, and a carer is needed to be in their home all day. The live-in carer will live and work in the client’s home. They will be provided with their own bedroom to get the rest they need. A live-in care client will need full-time care or companionship during the day but may also require some additional support during the night. If the client has very high needs, more than one live-in carer may be needed, or a combination of live-in and visiting care may be present. Live-in carers will get to know the client and their family well. Read more about the role of a live-in carer.

Employed vs self-employed

The next main difference in carer roles is whether a carer is employed by a care company or whether they are self-employed.

Self-employed carers

Being a self-employed carer, like with any self-employed roles, offers more freedom, but also increased risks. A self-employed carer can have more control over what opportunities they do and don’t take, and how often. As is the nature of self-employment however, a carer operating on their own won’t be entitled to holiday pay, a company pension scheme, PAYE entitlement, or representation and all the benefits that come with employment. Self-employed individuals will also incur additional tasks such as accounting and keeping their training up to date at their own expense. Self-employed carers can acquire clients privately or they can work with introductory care agencies who match clients with self-employed carers.

Benefits of being self-employed:

• Full choice over clients
• Earnings directly linked to hours worked, with high earnings potential
• Full flexibility of hours and days worked
• Carer can stay with the same client for longer

Drawbacks of being self-employed:

• Additional administrative duties such as tax returns
• No company sick pay or holiday pay entitlement
• Generally, will need to pay for their own training

Employed carers

Employed carers will have signed a contract of employment with a care company; this company is required by law to be regulated by the Care Quality Commission (CQC) if they are providing any personal care. For visiting carers, the contract should stipulate the expected hours of work per week and the company should make every effort to assign the carer enough clients to meet these hours. Employment contracts can range from zero-hours contracts to full-time work. Most care companies will still offer a degree of flexibility whilst being employed if the carer needs to increase or decrease their hours. However, an applicant should always be honest with their employer before starting regarding their availability and how much they want to work.

Benefits of being employed:

• Can often start work with less direct care experience (as basic training is provided)
• Holiday entitlement can be accrued
• Tax and NI paid automatically via PAYE
• Sick pay (depending on employer)
• No need to source a private client base
• Travel time and travel cost can be paid for by employer
• Possible Bonus and Reward schemes
• Free uniforms (tunics) often provided
• Potential for career progression and clearer development pathways
• Basic and advanced training can be provided

Drawbacks of being employed:

• Less freedom and choice of assignments
• Depending on carer availability, clients may change at short notice

Overnight carers

A carer that works during the day needs to get a full night’s sleep to be able to effectively work the following day. A lot of elderly, ill, and disabled adults are unable to sleep for a full night and may require some level of support during the night. This is where an overnight carer may be required.

There are two types of overnight carers:

Waking nights whereby the carer is expected to remain awake all night and sleep during the day and sleeping nights where the carer is expected to be asleep most of the night, but on call should they be needed.

Typically, a waking nights carer can expect to be paid more than a sleeping nights carer as they are awake and working during unsociable hours. This increased cost is usually passed onto the client.

Some care companies and agencies will look specifically for overnight carers, and others will delegate overnight shifts to carers on their books who are happy to work these shifts. Legally, all employers should ensure they are scheduling in a certain number of rest hours away from work before a carer who has worked an overnight shift can work another shift.

It is a very flexible role that takes many forms: there are employed and self-employed overnight carers, as well as visiting and live-in overnight carers.

Specialised carers

As a care worker develops their skillset and gains experience working with different clients or attending training courses, they will acquire the ability to better support clients with specific requirements, disabilities, or illnesses. This gives them the ability to care for a greater variety of clients, as opposed to caring for a more advanced specific type of client. However, a carer may decide that they are better suited to working with clients with particular needs.

Dementia carers

It is estimated that over 850,000 people in UK live with dementia*. Dementia is caused by several diseases that affect the brain, such as Alzheimer’s. Symptoms can include memory loss, difficulty concentrating, disorientation, problems with speech, and the inability to control motor and bodily functions. Caring for dementia clients in their home can help them live better and slows the deterioration by keeping them in familiar surroundings. A dementia carer will be specifically trained in how to support those with dementia.

*Dementia Information (england.nhs.uk)

Companionship carers

Loneliness is an increasing issue in the ageing population of the UK and a companionship carer can help greatly. There are many volunteer services in the UK that people can sign up to befriend an elderly person, however, there are still plenty of opportunities for professional carers to offer this service. Companionship may include care in someone’s own home, helping them attend events, complete daily errands, or even accompany them on holiday.

Respite carers

Respite care gives the primary care giver a break and a chance to recharge. Respite care offers the carer a chance to work with many different clients on one-off visits or live-in stays.

Palliative carers

Palliative care, also known as end-of-life care, supports clients who are terminally ill or near to passing away. This can be a visiting or a live-in role. They should also be able to emotionally support friends and family. They may also have to work closely with medical professionals.

Physical disability carers

This can cover a broad range of physical conditions from cerebral palsy to those who have suffered from a serious accident or injury. This can be a very physical care role as the client is often mentally capable but cannot complete daily tasks easily on their own, such as getting in and out of bed or leaving the house. Those living with disabilities often require emotional support too to help them with their mental wellbeing.

Other specialist care roles can include:

• Convalescence carer
• Parkinson’s carer
• Multiple Sclerosis (MS) carer
• Bariatric carer

It was estimated that there were over 1.67m jobs in adult social care in the UK in 2020/21. In comparison there are 1.3m jobs in the NHS.

– SKILLSFORCARE.ORG.UK

Our next section discusses the role of a live-in carer; the jobs that need to be undertaken and the expectation around shift patterns. Download our complete Guide to Becoming a Carer for free. Everything you need to know about becoming a carer in one handy pdf which you can print out or read digitally.